Prevalence, Antimicrobial Susceptibility Patterns, and Risk Factors Associated with Enterococci among Pediatric Patients at Dessie Referral Hospital, Northeastern Ethiopia

Abstract

Background. Enterococcus species, which is previously considered as medically not important, now becomes one of the leading causes of nosocomial infections. Even though it becomes the most public health concern and emerging multidrug-resistant pathogen, there is no enough data in the study area. Objective. To determine the prevalence, antimicrobial resistance pattern, and associated risk factors of enterococci infection in pediatric patients. Methods. A hospital-based cross-sectional study was conducted from February to May 2019 at Dessie Referral Hospital, Northeastern Ethiopia. A total of 403 pediatric patients were included in the study, and a pretested structured questionnaire was used to collect sociodemographic and risk factor-related data. Clinical samples such as urine, blood, wound swabs, discharges, and other body fluids were collected aseptically and inoculated on to Bile Esculin Azide Agar, and colony characteristics, Gram stain, catalase, salt, and temperature tolerance tests were employed for bacterial identification. Antimicrobial sensitivity tests were performed using the modified Kirby-Bauer disk diffusion method. Data was entered into SPSS software version 25 and descriptive statistics; bivariate and multivariate logistic regression analyses were performed. In all cases, a P value ≤ 0.05 with corresponding 95% confidence interval were considered as statistically significant. Result. The overall prevalence of enterococci was 2.7% (11/403). Of which, the highest number of enterococci infection was recovered from urine sample (54.5%) followed by blood (27.3%), wound swab (9.1%), and other body fluids (9%). The overall multidrug resistance rate was 54.5%. Higher drug resistance pattern was observed against tetracycline, chloramphenicol, and amoxicillin/clavulanate. Having history of invasive procedure ( P < 0.001 ), chronic illness ( P < 0.001 ) and previous admission history of the children ( P < 0.001 ) were statistically significant associated risk factors for pediatrics enterococci infection. Conclusion. The prevalence of enterococci from pediatric patients in this study was relatively low compared to other studies. Significant rates of MDR and VRE were identified, and the risk of infection became high when children had a history of different chronic illnesses and history of admission and underwent invasive treatment procedures. Therefore, efforts should be made to prevent enterococci infections and spread of multidrug-resistant enterococci.

Asymptomatic Carriage Rate, Multidrug Resistance Level, and Associated Risk Factors of Enterococcus in Clinical Samples among HIV‐Positive Patients Attending at Debre Birhan Comprehensive Specialized Hospital, North Showa, Ethiopia

“…This finding was comparable with a study report from Spain (80%) [52], India (82%) [53], Jimma, Ethiopia (89.5%, 80.8%) [25,49], southern Ethiopia (82.5%) [47], and Gondar (75%) [24]. However, it was considerably higher in comparison to other study findings from Dessie, Ethiopia (54.5%) [54], Germany (13.4%) [55], India (10%) [56], and Brazil (57%) [57]. The variations could be related to variances in This was the study's most remarkable finding, and it is a concerning indication of resistance's expanding prevalence.…”

A Retrospective Analysis of Culture-Confirmed Enterococci Bloodstream Infections in South Africa, 2016–2020: A Cross-Sectional Study

“…We observed a high proportion of enterococci among infants less than one year old. Other studies reported the same findings and also showed a significant association between pediatrics enterococcal infection and having a history of invasive treatment procedure/chronic illness, admission, or hospitalization [ 24 ]. However, our study did not explore such an association due to the absence of patient clinical data.…”

Gram-negative bacteria isolates and their antibiotic-resistance patterns among pediatrics patients in Ethiopia: A systematic review

“…Tetracyclines, chloramphenicol, and cotrimoxazole are commonly used medications to treat Salmonella infection in Ethiopia. 39 , 52 However, finding from this review indicated that Salmonella species were 93.30%, 78.26%, 63.64% resistant to tetracycline, chloramphenicol, and cotrimoxazole, respectively. These might be due to the overuse of these antibiotics in developing countries because of easy availability and low cost.…”

“…Moreover, irrationally prescriptions as empirical treatment options and over-the-counter use of these antibiotics are also common. 13 , 52 H influenzae was 100% resistant to meropenem. This will be challenged for future antibiotics therapy, since this drug is the last alternative for use when gram-negative bacteria are resistant to other commonly used antibiotics.…”